Podcast
Questions and Answers
The profunda brachii artery, a branch of the brachial artery, is MOST closely associated with which anatomical structure?
The profunda brachii artery, a branch of the brachial artery, is MOST closely associated with which anatomical structure?
- Radial groove (correct)
- Cubital fossa
- Bicipital aponeurosis
- Carpal tunnel
Which of the following structures does NOT contribute to the boundaries of the cubital fossa?
Which of the following structures does NOT contribute to the boundaries of the cubital fossa?
- Bicipital aponeurosis
- Brachialis (correct)
- Brachioradialis
- Pronator teres
A patient presents with an injury affecting the musculocutaneous nerve. Which muscle function would be LEAST affected?
A patient presents with an injury affecting the musculocutaneous nerve. Which muscle function would be LEAST affected?
- Shoulder flexion
- Shoulder adduction (correct)
- Forearm supination
- Elbow flexion
Which nerve is responsible for innervating the majority of the intrinsic muscles of the hand?
Which nerve is responsible for innervating the majority of the intrinsic muscles of the hand?
What is the MAIN arterial supply to the superficial palmar arch?
What is the MAIN arterial supply to the superficial palmar arch?
Which nerve passes through the carpal tunnel?
Which nerve passes through the carpal tunnel?
What movement occurs at the elbow joint during pronation and supination of the forearm?
What movement occurs at the elbow joint during pronation and supination of the forearm?
Which of the following muscles is NOT innervated by the radial nerve?
Which of the following muscles is NOT innervated by the radial nerve?
Which structure is located MOST proximally in the upper limb?
Which structure is located MOST proximally in the upper limb?
Which of the listed arteries typically contributes directly to the formation of the deep palmar arch?
Which of the listed arteries typically contributes directly to the formation of the deep palmar arch?
Following a fracture of the midshaft of the humerus, a patient exhibits wrist drop. Which nerve is MOST likely injured?
Following a fracture of the midshaft of the humerus, a patient exhibits wrist drop. Which nerve is MOST likely injured?
Which action would be MOST weakened by damage to the ulnar nerve at the wrist?
Which action would be MOST weakened by damage to the ulnar nerve at the wrist?
If a patient has difficulty with forearm pronation but their wrist flexion is normal, which muscle is MOST likely affected?
If a patient has difficulty with forearm pronation but their wrist flexion is normal, which muscle is MOST likely affected?
Which dermatome corresponds to the region of the lateral epicondyle?
Which dermatome corresponds to the region of the lateral epicondyle?
The tendon of which muscle forms the medial border of the anatomical snuffbox?
The tendon of which muscle forms the medial border of the anatomical snuffbox?
What spinal cord segment provides sensory innervation to the skin over the tip of the thumb?
What spinal cord segment provides sensory innervation to the skin over the tip of the thumb?
Which structure passes between the two heads of the pronator teres muscle?
Which structure passes between the two heads of the pronator teres muscle?
If a patient is unable to oppose their thumb, which muscle is MOST likely affected?
If a patient is unable to oppose their thumb, which muscle is MOST likely affected?
Which of the following muscles is primarily responsible for initiating abduction of the arm from 0 to 15 degrees?
Which of the following muscles is primarily responsible for initiating abduction of the arm from 0 to 15 degrees?
Which structure provides the PRIMARY blood supply to the carpal bones?
Which structure provides the PRIMARY blood supply to the carpal bones?
Which of the following muscles flexes both the wrist and the digits?
Which of the following muscles flexes both the wrist and the digits?
Which of the following muscles is NOT located in the thenar eminence?
Which of the following muscles is NOT located in the thenar eminence?
Which nerve is MOST at risk of injury with a fracture of the hamate hook?
Which nerve is MOST at risk of injury with a fracture of the hamate hook?
Which muscle would be MOST affected by damage to the long thoracic nerve?
Which muscle would be MOST affected by damage to the long thoracic nerve?
Which forearm muscle is innervated by the median nerve ONLY?
Which forearm muscle is innervated by the median nerve ONLY?
A patient has lost sensation on the anterior aspect of the forearm. Which nerve is MOST likely affected?
A patient has lost sensation on the anterior aspect of the forearm. Which nerve is MOST likely affected?
Which muscle inserts onto the intertubercular groove (bicipital groove) of the humerus?
Which muscle inserts onto the intertubercular groove (bicipital groove) of the humerus?
Which motion does the teres minor primarily perform at the glenohumeral joint?
Which motion does the teres minor primarily perform at the glenohumeral joint?
Which nerve root primarily innervates the deltoid muscle?
Which nerve root primarily innervates the deltoid muscle?
Flashcards
Upper limb's skeletal framework?
Upper limb's skeletal framework?
The skeletal framework of the shoulder joint, arm, elbow, forearm, wrist, and hand.
Upper limb's major nerves?
Upper limb's major nerves?
The major nerves of the upper limb, their course, and the muscles they innervate.
Boundaries of cubital fossa?
Boundaries of cubital fossa?
The boundaries of the cubital fossa include the pronator teres, brachioradialis, and a line joining medial/lateral epicondyles.
Upper limb's major blood vessels?
Upper limb's major blood vessels?
Signup and view all the flashcards
Arm's flexor muscles?
Arm's flexor muscles?
Signup and view all the flashcards
Arm's extensor muscle?
Arm's extensor muscle?
Signup and view all the flashcards
Movements at elbow?
Movements at elbow?
Signup and view all the flashcards
Bones of the elbow joint?
Bones of the elbow joint?
Signup and view all the flashcards
Action of Pronator teres and quadratus?
Action of Pronator teres and quadratus?
Signup and view all the flashcards
Main arteries of the forearm?
Main arteries of the forearm?
Signup and view all the flashcards
Superficial flexor muscles?
Superficial flexor muscles?
Signup and view all the flashcards
Intermediate forearm muscle?
Intermediate forearm muscle?
Signup and view all the flashcards
Deep flexor muscles?
Deep flexor muscles?
Signup and view all the flashcards
Superficial palmar arch?
Superficial palmar arch?
Signup and view all the flashcards
Deep palmar arch?
Deep palmar arch?
Signup and view all the flashcards
Thenar muscles?
Thenar muscles?
Signup and view all the flashcards
Hypothenar muscles?
Hypothenar muscles?
Signup and view all the flashcards
A vascular landmark of the wrist?
A vascular landmark of the wrist?
Signup and view all the flashcards
A vascular landmark of the wrist?
A vascular landmark of the wrist?
Signup and view all the flashcards
Study Notes
- Upper limb anatomy notes by Dr. Rajaram
Objectives
- Describe the skeletal framework of the shoulder joint, arm, elbow, forearm, wrist, and hand
- Describe elbow and wrist movements in relation to flexor and extensor orientation
- Describe the course of the major nerves of the upper limb and the muscles they innervate
- Describe the Cubital fossa and its boundaries and main contents
- Describe major blood vessels of the upper limb, including branches and distribution areas
- Describe dorsal and palmar aspects of hand muscles and their actions
- Describe the functions and innervation of intrinsic hand muscles and major vessels forming the superficial and deep palmar arches
- Podcast to be used a guideline in reading recommendations
- Muscle tables and clinical applications to be found in text books
- Blue link images for labeled and unlabeled cadaveric images can be found at https://sites.google.com/a/umich.edu/bluelink/resources/bluelink
Upper Limb Structures
- Biceps brachii
- Bicipital aponeurosis as compared to biceps brachii tendon
- Coracobrachialis
- Axillary artery
- Brachial artery
- Profunda brachii artery
- Ulnar & radial arteries
- Cephalic Vein
- Basilic Vein
- Axillary Vein
Arm Compartments
- Flexor muscles originate/insert on: -Biceps brachii -Coracobrachialis -Brachialis
- Terminal branches of brachial plexus cords
- Course of median & ulnar nerves
- Radial nerve & ulnar nerve located on exterior
- Blood supply
Brachial Plexus Recap
- Lateral cord contains: -Musculocutaneous -Lateral Pectoral -Lateral branch to median nerve
- Medial cord contains: -Medial Pectoral -Cutaneous nerves to arm & forearm -Ulnar -Medial branch to median nerve
- Posterior cord contains: -Upper & lower subscapular -Axillary -Radial -Thoracodorsal
Blood Vessels Transitioning from Arm to Elbow
- Axillary artery becomes brachial artery
- Anterior circumflex humeral / Posterior circumflex humeral
- Profunda brachii artery in radial groove
- Humeral nutrient artery
- Superior ulnar collateral
- Inferior ulnar collateral
- Radial collateral
- Middle collateral
- Interosseous recurrent
- Radial recurrent artery
- Anterior ulnar recurrent artery
- Posterior ulnar recurrent artery
- Common interosseous artery / Anterior interosseous artery
- Radial & ulnar arteries in forearm
- Inferior margin of teres major is the area where the Basilic vein penetrates deep fascia
Elbow and Forearm
- Movements occuring at the elbow include flexion, extension, pronation and supination: -Flexion, Extension -Pronation: Palm posterior -Supination: Palm anterior
Elbow Joint
- Bones: humerus, ulna & radius
- Ligaments: -Annular -Collateral
- Cubital fossa is bound by: -Pronator teres -Brachioradialis -A line joining the medial & lateral epicondyles
- Cubital fossa roof contains the median cubital vein
- Cubital fossa contents: -Tendon of biceps -Brachial artery -Median nerve
Ulna & Radius features
- Radial tuberosity
- Oblique line
- Anterior border
- Lateral surface
- Interosseous border
- Posterior surface
- Interosseous border
- Ulnar notch
- Radial styloid process
- Dorsal tubercle
- Facet for articulation with lunate bone
- Facet for articulation with scaphoid bone
- Trochlear notch
- Coronoid process
- Radial notch
- Tuberosity of ulna
- Anterior surface
- Interosseous border
- Medial surface
Primary Forearm Movers
- Bicep Brachii contracts for supination
- Supinator assists with supination
- Pronator teres and pronator quadratus contract for pronation
Forearm Muscles
- Superficial forearm muscles: -Pronator teres -Flexor carpi radialis -Palmaris longus -Flexor carpi ulnaris
- Intermediate forearm muscles: -Flexor digitorum superficialis
- Deep forearm muscles: -Flexor digitorum profundus -Flexor pollicis longus -Pronator quadratus
Vascular Supply in the Forearm
- Radial artery: branch of brachial artery (runs beneath brachioradialis to wrist)
- Ulnar artery: branch of brachial artery (runs beneath FCU towards wrist)
- Common interosseous artery: branches to supply flexor and extensor muscles
- Anterior & posterior interosseous arteries
Hand
- Palmar Arches
- Radial artery provides Deep palmar arch
- Ulnar artery provides superficial palmar arch
- Vascular -Ulnar forms most arches -Note digital branches
- Pulse -Radial felt
- Bones include: -Phalanges, metacarpals and carpals
Hand & Fingers
- Phalanges: Distal, Middle, Proximal
- Movement: -Abduction -Adduction
- Carpal bones (proximal row): scaphoid, lunate, triquetrum, pisiform
- Carpal bones (distal row): trapezium, trapezoid, capitate, hamate
Sensory innervation of the hand
- Ulnar nerve- one and a half fingers
- Median nerve-Lateral 3 and a half fingers
- Superficial branch of radial nerve-Dorsum of hand thumb and index fingers
Muscles of the Hand
- Function based on name, function determined by names and the area it innervates
- Thenar muscles innervated by recurrent branch of median nerve -Flexor pollicis brevis -Abductor pollicis brevis -Opponens pollicis
- Hypothenar muscles innervated by deep branch of ulnar nerve -Flexor digiti minimi -Abductor digiti minimi -Opponens digiti minimi
- Dorsal and palmar Interosseous muscles- innervated deep branch of ulnar nerve -Dorsal interossei abduct -Palmar interossei adduct the fingers
- Lumbricals (medial 2)- deep branch of ulnar nerve
- Lumbricals (lateral 2)- median nerve
- Adductor pollicis innvervated by deep branch of ulnar nerve. Adduction of thumb
Wrist and Hand Movements
- Movements at wrist correlates with muscles studied in flexor and extensor compartments, including: -Flexion & Extension -Abduction / lateral deviation -Adduction / medial deviation
- Fingers: -Flexion and extension of thumb -Abduction of thumb -Opposition -Fingers- adduction and abduction. -Flexion of fingers at MCP joints -Flexion of fingers at PIP & DIP joints
Nerves supply to the Forearm
- At the elbow the radial nerve innervates few extensor muscles and the supinator
- The Median nerve intervates: -Pronator teres -Flexor carpi radialis (FCR) -Palmaris longus (PL) -Flexor digitorum superficialis (FDS) -Lateral half of flexor digitorum profundus (FDP) -Flexor pollicis longus -Pronator quadratus
- Ulnar Nerve -Flexor carpi ulnaris (FCU) -Medial half of flexor digitorum profundus
Muscles
- Muscles, innervation and blood can be broken down by the specific compartment (extensor) Brachioradialis
- Anterior view-Anconeus
- Posterior view: -Extensor carpi ulnaris -Extensor digiti minimi -Extensor digitorum -Extensor carpi radialis longus -Extensor carpi radialis brevis
- Posterior view Abductor pollicis longus and Extensor pollicis brevis -Extensor pollicis longus -Extensor indicis
- Lateral side of distal forearm exhibits a muscular bulge.
Dermatomes
- Segmental cutaneous branches from respective ventral and dorsal rami innervate the back, lateral and anterior wall of thorax
- Shoulder, arm, forearm & hand: Spinal segments are labeled in image
- Sensations in respective shaded areas are from the spinal nerves (as part of the nerve they belong to depending on the brachial plexus).
- Example: Medial one and half fingers sensations carried by ulnar nerve (C8, T1).
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
